Alcohol and cancer risk: What we know

Most people know about the connection between cigarettes and cancer risk, but does drinking cause cancer? It’s something rarely discussed, despite years of evidence that alcohol increases cancer risk.

In fact, a recent report from the U.S. Surgeon General stated that alcohol consumption was the third leading preventable cause of cancer in the U.S., behind tobacco use and obesity.

Yet many Americans aren’t aware of the connection between alcohol and cancer risk. According to the 2024 American Association for Cancer Research (AACR) Cancer Progress Report, only about half of Americans who took a recent survey knew about the increase in risk that can come with alcohol consumption.

“There used to be a belief that a ‘glass of wine a day keeps the doctor away,’ but that is slowly being pulled back to moderate, moderate, moderate,” says Ashley Hendershot, DNP, FNP-C, ACGN, advanced clinical genomic nurse at Wilmot Cancer Institute.

Hendershot works with Wilmot’s Hereditary Cancer Screening and Risk Reduction Program and routinely talks with patients who are at increased risk of cancer about ways they can reduce their risk, including controlling alcohol consumption. She answered some common questions about alcohol and cancer risk.

Cancers linked to alcohol consumption

The six known alcohol-related cancers are:

• Colorectal cancer
• Female breast cancer
• Certain types of head and neck cancers
• Liver cancer
• Esophageal cancer
• Stomach cancer

Drinking alcohol may increase your risk of any of these, but that increase varies by the type of cancer and the amount of alcohol consumed.

How much alcohol is safe?

Alcohol is a known carcinogen, meaning any amount can contribute to cancer risk. If you don’t drink, it’s best not to start. If you do, limiting intake is key to reducing risk.

“The initial recommendation was moderation, but research confirms the main issue: alcohol is a carcinogen,” says Hendershot.

The AACR advises drinking as little as possible. Moderate drinking is defined as:

• Women: Up to 1 drink per day
• Men: Up to 2 drinks per day

A standard drink is considered:

• 12 ounces of beer (5% alcohol)
• 5 ounces of wine (12% alcohol)
• 1.5 ounces of spirits (40% alcohol)

How does alcohol increase cancer risk?

When alcohol breaks down in the body, it creates a chemical called acetaldehyde, which causes DNA damage. DNA damage can be errors or variations in the DNA. If your body doesn’t “fix” the errors through your immune system or other mechanisms, it can lead to cancer.

Alcohol also depletes things like folic acid, which our bodies need for DNA damage repair. Additionally, alcohol can lead to higher rates of circulating estrogen, which may increase a person’s chances of the types of breast cancer fueled by these hormones.

“A lot of studies around the harm of alcohol after a breast cancer diagnosis have led us to encourage our breast cancer survivors to really try to moderate their alcohol, or not drink alcohol at all,” she says.

Alcohol is also “empty calories”— it is not doing anything helpful for the cells in our bodies but is adding energy our bodies may not need, which can lead to weight gain. Obesity is another factor tied to cancer risk.

What should I do if I’m concerned about alcohol use and my cancer risk?

The AACR report says those who reduce alcohol consumption or stop drinking can reduce their chances of all cancers by 4% and of alcohol-related cancers by 8%.

Keep in mind that alcohol is only one of many factors that could contribute to the development of cancer. Knowing about and understanding what the latest data says can be exhausting, but that’s where Hendershot and her team can help.

They work with patients who have a family history or personal history of cancer to help them understand what the science says now and what their own personal risk is, so they can be informed.

“Our goal is to prevent as many cancers as possible,” Hendershot says. “We are happy to counsel our patients so they can make educated decisions about how they live their lives.”

What are other behaviors that can impact a person’s cancer risk?

The AACR Report also named other research-backed ways to reduce your cancer risk:

• Eliminate tobacco use.
• Maintain a healthy weight, eat a healthy diet, and stay active.
• Protect skin from UV exposure.
• Prevent and eliminate infection from cancer-causing pathogens.
• Limited exposure to environmental risk factors.
• Be cognizant of hormonal factors.